Boarding Release Form

Items brought with my pet

I authorize Kibby Park Animal Hospital to make charges to my account of up to $ ______________ in case of necessary medical treatment or emergency. Stress-related conditions, such as anxiety, which may lead to diarrhea or injury will also be addressed at a charge of $3–$6 per day ONLY if determined to be medically necessary. If over the stated amount, please contact me at the number above OR my emergency contact person if I cannot be reached.

By submitting this form, I grant Kibby Park Animal Hospital, its representatives, and employees the right to take photographs of me and/or my pet, and to copyright, use, and publish the same in print and/or electronically. I also agree that Kibby Park Animal Hospital may use such photographs of me and/or my pet with or without my name and for any lawful purpose including, for example, such publicity, illustration advertising, and web content.